The Care Quality Commission
  • Doctor
  • GP practice

The Dunstan Partnership

Overall: Good read more about inspection ratings

Breightmet Health Centre,, Breightmet Fold Lane, Breightmet,, Bolton, Lancashire, BL2 6NT (01204) 463777

Provided and run by:
The Dunstan Partnership

All Inspections

During an assessment under our new approach

Date of assessment: 7 March 2024. The Dunstan Partnership is an NHS GP Practice which provides primary care services to patients in Bolton, Greater Manchester. We carried out an announced assessment of one quality statement, equity in access, under the responsive key question. We found the practice had organised services to meet patients’ needs, particularly those who were most likely to have difficulty accessing care. The practice sought out and used feedback and other data and information to monitor and improve access. We carried out the assessment as part of our work to understand how practices are trying to meet people’s demands for access and to better understand the experiences of people who use services and providers. We recognise the work that GP practices have been engaged in to continue to provide safe, quality care to the people they serve. We know staff are carrying this out whilst the demand for general practice remains exceptionally high, with more appointments than ever being provided. However, in this challenging context, access to general practice remains a concern for people. Our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. The assessment of the quality statement equity of access includes looking at what practices are doing innovatively to improve patient access to primary care and sharing this information to drive improvement. Overall, the practice is rated as good and the key question responsive continues to be rated as providing a good service.

11 July 2022

During a routine inspection

We carried out an announced inspection at The Dunstan Partnership on 11 July 2022. Overall, the practice is rated as good, with the following key question ratings:

Safe - Good

Effective - Good

Caring - Good (rating awarded at the inspection 13 November 2018).

Responsive - Good (rating awarded at the inspection 13 November 2018).

Well-led - Good

Our previous inspection was on 13 November 2018, and the practice had been rated good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Dunstan Partnership on our website at www.cqc.org.uk

Why we carried out this inspection

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach. This inspection was a focused inspection looking at the key questions Safe, Effective and Well-led.

How we carried out the inspection/review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify issues and clarify actions taken by the provider
  • Requesting evidence from the provider
  • Gaining feedback from staff by using staff questionnaires.
  • A short site visit

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall and as good in all key questions

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Although there were no breaches of regulation, the provider should:

  • Code the parents or family members of children on the safeguarding register.
  • Routinely request a full employment history of new staff, checking the reasons for gaps in employment.
  • Review Patient Group Directions (PGDs) to ensure clinicians are correctly authorised to administer medicines.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

During a routine inspection

This practice is rated as Good overall. (Previous rating December 2014 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at The Dunstan Partnership on 13 November 2018 as part of our inspection programme.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • Staff took steps, including working with other agencies, to protect patients from abuse, neglect, discrimination and breaches of their dignity and respect.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff had the skills, knowledge and experience to carry out their roles. The practice understood the learning needs of staff and provided training to meet them.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The practice gave patients timely support and information. The practices GP patient survey results were above and in line with local and national averages for questions relating to kindness, respect and compassion.
  • The practice understood the needs of its population and tailored services in response to those needs.
  • The practice had been awarded the Pride in Practice award which included training in health care for lesbian, gay, bisexual and transgender patients.
  • Leaders had the capacity and skills to deliver high-quality, sustainable care.
  • There were clear responsibilities, roles and systems of accountability to support good governance and management.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

The practice had found that patients with long term conditions often contacted out of hours services during the evening and at weekends more frequently. A GP now makes a courtesy call to the patient on a Friday afternoon to see if they had any specific needs that required attention before the weekend. This had reduced the need for those patients to contact the out of hours service.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

4 December 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

The Dunstan Partnership was inspected on the 4 December 2014.This was a comprehensive inspection.

We rated The Dunstan Partnership as Outstanding in relation to being responsive and good in relation to being safe, effective, caring, and well-led.

Our key findings were as follows:

Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses. Systems were in place to manage medicines and prescriptions safely and for managing infection prevention and control.

The practice had systems in place to ensure best practice was followed. This was to ensure that people’s care, treatment and support achieved good outcomes and was based on the best available evidence.

Information we received from patients reflected that practice staff interacted with them in a positive and empathetic way. They told us that they were treated with respect, always in a polite manner and as an individual.

Patients spoke positively in respect of accessing services at the practice. A system was in place for patients who required urgent appointments to be seen the same day.

We saw areas of outstanding practice including;

GPs personally telephoned all patients identified as “at risk of hospital admission” if they had been admitted and then discharged from hospital to conduct an initial post discharge review as soon as possible. The purpose of this was to initiate speedy appropriate action to prevent the patient being re-admitted to hospital if possible.

The practice had achieved the ‘Pride in practice gold award’ (in March 2014) to celebrate their dedication to delivering an excellent service to all patients. Pride in Practice is a quality assurance support service provided by The Lesbian & Gay Foundation to GP practices to support improvements in health outcomes for their lesbian, gay and bisexual (LGB) patients, as well as strengthen their engagement with, and understanding of LGB people.

To improve patient access the practice was open from 7am until 7.30pm Monday to Friday. These hours of access were particularly helpful to patients who work.

The continuing development of staff skills, competence and knowledge was recognised as integral to ensuring high-quality care. Staff were proactively supported to acquire new skills and share best practice. Staff training records and discussions with staff demonstrated that all grades of staff were actively encouraged to access regular training to enable them to develop professionally and meet the needs of patients effectively.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice